Objective To evaluate the safety and efficacy of combined transcatheter intraarterial chemoembolization with 350-560 μm gelatin sponge particles and lobaplatin (GSPs-TACE) and oral Chinese herb medication Huaier granules in patients with hepatocellular carcinoma (HCC).Methods This is a case-control,single-institution clinical trial.31 HCC patients receiving GSPs-TACE (group A) were matched with 31 patients receiving GSPs-TACE and Huaier granules (group B).Tumor response was evaluated by CECT using response evaluation criteria in solid tumors at 1 month after initial GSPs-TACE.The overall survival was calculated from the data of initial GSPs-TACE using the Kaplan-Meier method.Results The overall mean follow-up period was 28.7 (range 12-42) months.The overall 6-and 12-month survival rates in group A and group B were 90.3％ and 80.6％ vs 100％ and 93.5％,respectively.There was statistically significant difference in 12-month survival rates (x2 =5.213,P ＜0.05).Median survival time respectively was 17.1 and 20.6 months(x2 =0.745,P ＞0.05).The average TACE times were (4.1 ±7.3) and (2.9 ±8.7) respectively in group A and group B (P =0.01).Tumor objective response rate was statistically different in 6-and 12-month in two arms(x2 =5.945,6.384,P ＜0.05).There was no statistically significant difference in complications (respectively x2 =0.435,0.485,2.037,0.137,0.325,all P ＞ 0.05).Conclusions Huaier granules combined with transcatheter intraarterial chemoembolization with 350-560 μm gelatin sponge particles and carboplatin for HCC is safe and effectively prolongs patients' survival.

OBJECTIVETo compare the efficacy of different points combination in the treatment of menopausal insomnia.

METHODSNinety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia.

RESULTSThe parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P < 0.05, P < 0.01). The SL and awaking time (AT) in group C [SL (401.08 +/- 16.54) min and AT (4.87 +/- 2.64) times] were significantly superior to those in the other two groups [SL (50.36 +/- 18.47) min, (54.87 +/- 20.92) min, AT (5.98 +/- 2.11) times, (6.13 +/- 3.04) times, all P < 0.05]. The S(3+4) (%) in group C was also significantly higher than those in the other two groups (both P < 0.05). It was indicated by PSQI that the sleep quality of group C (0.78 +/- 0.12) was significantly superior to that in group B (1.32 +/- 0.29), the total score and cured and markedly effective rate in group C [(4.34 +/- 1.43), 68.8% (22/32)] were superior to those in group A [(7.48 +/- 3.09), 53.1% (17/32), both P < 0.05].

CONCLUSIONEar acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Menopause ; psychology ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

Objective To explore the implementation styles on the therapeutic effects on the neurosurgical intensive care unit (NICU) patients. Methods Patients were enrolled during February 3, 2015 to February 3, 2016. The key point time was August 3, 2015 when the treatment in our NICU was fully implemented by NICU professional doctors. Based on this time point, all the enrolled patients were divided into non-NICU professional doctor implementing (NNPDI) group and NICU professional doctor implementing (NPDI) group. Thus non-NICU professional doctors and professional doctors were the leaders of diagnosis and treatment in tow groups. The length of hospital stay, complications, prognosis and other therapeutic outcomes were compared between two groups. Results The length of hospital stay was longer in NPDI group than that in NNPDI group (P<0.05). The incidence of water-electrolyte imbalance was lower in NPDI group than that in NNPDI group (P<0.05). There were no significant differences in the incidence of the ventilator-associated pneumonia (VAP), the hepatic and renal insufficiency, the intracranial infections and stress ulcers between the two groups (P>0.05). The proportion of referral to other wards and fatality rate were both lower in NPDI group than those in NNPDI group (P<0.05). And the discharge rate from NICU was higher in NPDI group than that of NNPDI group (P<0.05). There was no significant difference in the rate of patients left hospital without treatment between the two groups (P>0.05). Conclusion The NICU professional doctor implementing may be contribute to, at least in part, the improving of prognosis of NICU patients without obvious advantages in most complications. The level of professional management remains to be improved.

OBJECTIVE: To determine the mass scores of naringin and neohesperidin in Fructus aurantii and Citrus chang-shan-huyou with their processed products and evaluate the quality of Fructus aurantii and Citrus changshan-huyou with their pro-cessed products. METHODS:According to the requirements of Chinese Pharmacopoeia(2010 edition)and Zhejiang Province Tradi-tional Chinese Medicine Preparation Standards (2005 edition),the moisture and ash of F. aurantii and C. changshan-huyou with their processed products were detected. And the contents of naringin and neohesperidin were determined. The ZORBAX SB-C18 column was used with the mobile phase of acetonitrile-water(20∶80,V/V)at the flow rate of 1.0 ml/min. The detection wave-length was set at 283 nm,and the column temperature was 40℃.The samples size was 10μl. RESULTS:The moisture of F. au-rantii and C. changshan-huyou was decreased after processing with no obvious change for ash. The contents of naringin and neohes-peridin were decreased,significantly for F. aurantii,and all consistent with the requirements of Chinese Pharmacopoeia(2010 edi-tion)except F. aurantii. The linear range was 0.028 45-0.284 5μg(r=0.999 7)for naringin and 0.085 9-0.858 6μg(r=0.999 6)for neohesperidin;the RSDs of precision,stability and reproducibility tests were no more than 1.36% and the average recovery was re-spectively 96.45%-100.43%(RSD=1.45%,n=6) and 98.36%-102.00%(RSD=1.26%,n=6). CONCLUSIONS: There was no significant difference in the inspection and determination re-sults in F. aurantii and C. changshan-huyou. It is suggested to adjust the limitation of content determination in the Chinese Pharmacopoeia(2010 edition)and processed standards.

Objective:To investigate the clinical effect of remote injection device assisted percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures.Methods:Using retrospective research and analysis methods, 168 patients with osteoporotic vertebral compression fractures admitted to Heze Municipal Hospital from September 2019 to August 2020 were selected. A total of 139 cases were followed up, with a follow-up rate of 82.7%, including 22 males and 117 females, with an average age of 74.17 years. According to the different equipment used, they were divided into two groups. Seventy-two cases used remote injection device to assist percutaneous vertebroplasty (observation group), 67 cases used traditional puncture needle puncture percutaneous vertebroplasty (control group). All patients were completed follow-up at 3 months after surgery. The operation time, intraoperative blood loss, bone cement injection volume, bone cement leakage rate, VAS score and ODI score of 1 day, 1 month and 3 months after operation were observed. Measurement data were expressed as ( Mean± SD), using t test, counting data were expressed as percentage [ n(%)], using χ2 test. Results:Both groups of patients successfully completed the operation without complications such as paraplegia, pulmonary embolism, or infection. There was no statistically significant difference between the two groups in operation time of two groups[(47.71±6.05) min vs (47.61±5.66) min, t=0.100, P=0.920]. The intraoperative blood loss of the two groups was no statistically significant difference [(7.08±3.00) mL vs (8.06±3.48) mL, t=1.782, P=0.079]. The difference between two groups of the amount of bone cement injected was statistically significant, [(6.44±1.03) mL vs (5.73±1.41) mL, t=3.369, P=0.001]. The bone cement leakage rate of the observation group was 27.78% (19/72), and the control group was 43.28% (29/67), and there was statistically significant( χ2=4.382, P=0.036). The preoperative VAS score of the observation group was (6.75±1.14) , and the control group was (6.64±1.08), and there was no significant difference between two groups( t=0.583, P=0.561) The VAS scores of the observation group and the control group were (1.28±0.75) and (1.21±0.77) respectively at 1 day after surgery. There was no statistically significant difference between two groups( t=0.583, P=0.588). The VAS scores of the observation group and the control group were (0.89±0.76) and (1.09±0.67) respectively at 1 month after operation. There was no statistically significant difference between two groups( t=1.641, P=0.103). The VAS scores of the observation group and the control group were (0.74±0.63) and (0.87±0.74) respectively at 3 months after operation. There was no statistically significant difference between two groups( t=1.118, P=0.266). The preoperative ODI scores of the observation group and the control group were (60.32±7.46) and (61.96±9.76) respectively, and there was no statistically significant difference between two groups( t=1.121, P=0.264). The ODI scores of the observation group and the control group were (14.93±6.01) and (15.10±6.43) respectively at 1 day after operation, there was no statistically significant difference between two groups( t=0.161, P=0.872). The ODI scores of the observation group and the control group were (10.54±4.24) and (11.31±3.71) respectively at 1 month after operation, and there was no statistically significant difference between two groups( t=1.136, P=0.258). The ODI scores of the observation group and the control group were (10.64±3.70) and (10.39±3.74) respectively at 3 months after operation, and there was no statistically significant difference between two groups( t=0.396, P=0.693). Conclusion:Compared with traditional puncture needle puncture percutaneous vertebroplasty, the remote injection device assisted percutaneous vertebroplasty has a definite clinical effect in the treatment of osteoporotic vertebral compression fractures, and the bone cement leakage rate is low.

Objective To explore the causal association between gut microbes and non-alcoholic fatty liver disease(NAFLD)by Mendelian randomisation analysis.Methods Genetic instrumental variables for gut microbiota were identified from a gene-wide association study of 18 340 participants,and summary statistics for NAFLD were ob-tained from the FinnGen database,which provided data on 894 NAFLD cases and 217 898 controls using the IVW method as the primary analysis.In order to test the robustness of the results,MR-Egger method,WM method,Simple Mode method,Weighted Mode method were used for Mendelian randomisation analysis,and heterogeneity test,sensitivity analysis,and multiplicity analysis were performed.Results class Gammaproteobacteria IVW re-sults showed(OR=0.621,95％CI=0.412～0.934,P=0.022);family Enterobacteriaceae IVW results showed(OR=1.481,95％CI=1.069～2.053,P=0.018);genus Lachnospiraceae IVW results showed(OR=1.405,95％CI=1.036～1.904,P=0.029);genus Prevotella7 IVW results showed(OR=0.834,95％CI=0.714～0.974,P=0.021);genus Prevotella9 IVW results showed(OR=1.251,95％CI=1.025～1.527,P=0.027);order Desulfovibrionales IVW results showed(OR=0.714,95％CI=0.519～0.982,P=0.038);or-der Enterobacteriales IVW results showed(OR=1.481,95％CI=1.069～2.053,P=0.018).And there was no heterogeneity in the heterogeneity test,and the sensitivity analyses all showed robustness and no pleiotropy was found.Conclusion This study implicates class Gammaproteobacteria,family Enterobacteriaceae,genus Lachno-spiraceae,genus Prevotella7,genus Prevotella9,order Desulfovibrionales,order Enterobacteriales seven species of gut microorganisms have a causal relationship with NAFLD.

Objective To study the surgical treatment and effects of the lesions in the third ventricle. Methods The data of 15 patients with third ventricular lesion, accepted surgical treatment were retrospectively analyzed. The lesions were removed through transcallosal approach in 11 patients, frontal trans-cortical approach in 2 and trans-terminalis approach in 2,respectively. Postoperative radiotherapy was performed in 5 and chemotherapy in 2. VP shunt was performed in 1. Results The lesions were total-resected in 8 (53.3%), subtotal-resected in 5 (33.3%) and partial-resected in 2 (13.3%) with 1 postoperative death. The hydrocephalus were resolved in all cases. With a follow-up of 3 to 12 months, all the 14 patients recovered without obvious neurological deficits. Conclusion Proper microsurgical approach and perfect surgical skills are the keys to high resection and good prognosis. And postoperative radiotherapy or chemotherapy may be helpful in improving the outcome

Objective To investigate the clinical features of recurrent epileptic seizures and perioperative management principles and methods of neurosurgical patients with recurrent epileptic seizures.Methods The clinical data,reasons for aggravated seizures,seizure characteristics,and treatment methods and results of 9 patients with recurrent epileptic seizures were analyzed retrospectively.Results Of all the 9 patients,3 were combined with glioma,1 with arachnoid cyst,1 with cavernous hemangioma and 1 with encephalomalacia; epilepsy history was noted in 7 patients; frontal lobe epilepsy was noted in 7,and temporal lobe epilepsy in 2.The reasons for seizure aggravation included drug-decrement(n=3),recent-diagnosed brain tumor(n=2)and surgical operation during intracranial electrode implantation(n=1); and unknown reason was noted in the other 3.Epileptic seizure types included partial seizure and secondary generalized seizure; the frequency of seizure ranged from 3 minutes of interval to several hours of interval.Patients given multiple antiepileptic drugs,including oral and parenteral administration,received good seizure-control; and levetiracetam showed good curative effect during the treatment.Conclusion Recurrent seizures show drug refractory,and is hard to control.The AEDs having good curative effect in partial seizure should be combined used in these patients with higher dosage than conventional initial dose; intravenous and intramuscular administration can be used; the seizures should be controlled as soon as posible.Levetiracetam has good curative effect on patients with recurrent seizures for its fast oral-absorption,rapid onset of action and good antiepileptic effect.

OBJECTIVETo explore the better therapy for peripheral facial paralysis.

METHODSOne hundred and twenty patients were randomized into three groups: a common acupuncture group: acupuncture at Yangbai (GB 14), Sibai (ST 2) and Yingxiang (LI 20) as main acupoints, a ST 9 group: acupuncture at Renying (ST 9) as main and a ST 9 plus SGB group: acupuncture at Renying (ST 9) as main cooperated with stellate ganglion block (SGB). Once daily, 7 treatments made one session. After three sessions of treatment, the latency period and amplitude of evoked potential in ENoG, R1 value and R2 value of blink reflex were compared before and after the treatment in different groups separately. The total therapeutic effect was evaluated after treatment.

RESULTSAll the treatments shortened the latency period of ENoG, and elevated the amplitude evoked potential significantly. After treatment, the latency period in ST 9 plus SGB group was reduced significantly as compared with common acupuncture group (P < 0.05). The amplitude of evoked potential in ST 9 group was increased significantly as compared with the other two groups (both P < 0.05). After treatment, in each group, R1 and R2 values were shortened significantly. The difference values of R1 and R2 in ST 9 group and ST 9 plus SGB group were all significantly higher as compared with common acupuncture group (both P < 0.05). Additionally, the difference value of R1 in ST 9 plus SGB group was higher significantly than that in ST 9 group (P < 0.05). The clinical cured and remarkably effective rate was 87.5% (35/40) in ST9 plus SGB group, which was higher than 77.5% (31/40) in ST 9 group, and 65.0% (26/40) in common acupuncture group (P < 0.05).

CONCLUSIONAs compared with common acupuncture group, ST 9 group and ST 9 plus SGB group achieve the much superior efficacy on peripheral facial paralysis. The treatment with ST 9 acupuncture and SGB can better repair the early reflex induced by the injury of facial nerve.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Autonomic Nerve Block ; Combined Modality Therapy ; Facial Nerve ; physiopathology ; Facial Paralysis ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stellate Ganglion ; physiopathology ; Young Adult

OBJECTIVETo investigate the correlation between clinicopathologic factors and peritoneal dissemination in colorectal cancer, and the impact of surgery on the prognosis of patients with peritoneal dissemination.

METHODSBased on the clinical database built in 1994, the clinicopathologic data and the result of follow-up of all colorectal cancer patients were analyzed retrospectively.

RESULTOne hundred and fifty cases (7.40%) in all 2019 patients with primary colorectal cancer were found complicated with peritoneal dissemination. The clinicopathologic factors in patients with peritoneal dissemination were significantly correlated with tumor penetrating through serosa, lymph node metastasis, undifferentiated carcinoma, ascites, different pathological type, circumference of tumor, neoplastic intestinal obstruction, and Dukes staging. Peritoneal dissemination was associated with tumor penetrating through serosa, different pathological type on multivariate analysis. The 1-, 3-, 5-year survival rate of the patients with peritoneal dissemination were 70.4%, 38.1%, 30.2%; The 1-, 3-, 5-year survival rate of the patients undergoing radical resection were significant better than those in the cases undergoing palliative operation or palliative resection (P < 0.05).

CONCLUSIONSColorectal cancer complicated with peritoneal dissemination has poorer clinicopathologic characteristics. Those with local peritoneal dissemination has rather better prognosis than those with wide peritoneal dissemination. Radical resection of the disseminated tumor can improve the prognosis of the patients.

Colorectal Neoplasms ; pathology ; surgery ; Follow-Up Studies ; Humans ; Neoplasm Invasiveness ; Neoplasm Seeding ; Peritoneal Neoplasms ; secondary ; Prognosis ; Retrospective Studies ; Survival Analysis